Diagnosis information

Bipolar II disorder

Core diagnostic criteria, specifiers, differential considerations, and documentation support in one open, scan-friendly view.

F31.81Mood DisordersLocal clinical reference

Criteria: 5 criteria, A–E
Specifiers: 10 specifiers
Differentials: 6 considerations
Severity specifier: Supported

Core diagnostic criteria

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A
Core criterion A
Hypomanic episode threshold has been met.
B
Core criterion B
Major depressive episode threshold has been met.
C
Core criterion C
There has never been a manic episode.
D
Core criterion D
The mood episodes are not better explained by schizoaffective disorder or another schizophrenia-spectrum or psychotic disorder.
E
Core criterion E
The pattern causes clinically significant distress, functional impairment, or clinically important instability requiring diagnostic attention.

Key features

A.≥1 hypomanic episode + ≥1 major depressive episode; never a full manic episode
B.Hypomanic/depressive episodes not better explained by schizoaffective or other psychotic disorder
C.Clinically significant distress or impairment in functioning

Specifiers

Current or most recent episode: Hypomanic / Depressed: Identifies polarity of current or latest episode.
With anxious distress: Prominent tension, restlessness, or worry.
With mixed features: Concurrent hypomanic and depressive symptoms.
With rapid cycling: ≥4 mood episodes within 12 months.
With mood-congruent psychotic features: Psychosis aligned with depressive themes (not applicable during hypomania).
With mood-incongruent psychotic features: Psychosis not aligned with depressive themes.
With melancholic features: Anhedonia, psychomotor disturbance, diurnal variation.
With atypical features: Mood reactivity, hypersomnia, increased appetite, rejection sensitivity.
With peripartum onset: Onset during pregnancy or within four weeks postpartum.
With seasonal pattern: Depressive episodes show seasonal recurrence.

Documentation support

Consistent with [Bipolar II Disorder] [specifier(s)]. Across distinct episodes, there have been periods of elevated or expansive mood; irritable mood; inflated self-esteem; grandiosity; decreased need for sleep; increased talkativeness; pressured speech; flight of ideas; racing thoughts; distractibility; increased goal-directed activity; psychomotor agitation; engagement in risky activities, forming a pattern meeting the threshold for a hypomanic episode with at least four consecutive days and at least three of the above symptoms (or four when mood is irritable). In addition, there have been major depressive episodes characterised by depressed mood; markedly diminished interest; significant appetite or weight change; insomnia; hypersomnia; psychomotor agitation; psychomotor retardation; fatigue; loss of energy; feelings of worthlessness; excessive guilt; impaired concentration; indecisiveness; recurrent thoughts of death; suicidal ideation, meeting the threshold for a depressive episode over at least two weeks. These symptoms have resulted in clinically significant distress or impairment, and the pattern is not better accounted for by schizoaffective disorder, schizophrenia spectrum disorders, substance/medication effects, or a primary medical condition.

Adapt this supplied template to the assessment. It is not a substitute for diagnostic reasoning or local documentation requirements.

DSM-5 DiagnosisDSM-mood-bipolar-ii-disorderSupplied local catalogue